Who Recommends COVID-19 Vaccines Without ACIP? Goad, PharmD

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In May 2026, the FDA’s Vaccines and Related Biological Products Advisory Committee (VRBPAC) recommended that COVID-19 vaccines for the 2026-2027 season target the JN.1-lineage XFG variant.¹

The decision aligned with trends documenting seasonal upticks in COVID-19 cases, as reports of the BA.3.2 variant, commonly known as Cicada, increased in the spring and XFG, known as Stratus, later became the most common variant detected in Bay Area wastewater.^2,3 Yet the current recommendation process for COVID-19 vaccines was missing a key recommendation from the CDC’s Advisory Committee on Immunization Practices (ACIP), Jeffery A. Goad, PharmD, MPH, professor of pharmacy practice at Chapman University School of Pharmacy, said in an interview with The American Journal of Managed Care^® (AJMC^®). VRBPAC typically recommends COVID-19 vaccines first, then ACIP. Unlike influenza vaccines, which have a perpetual recommendation, COVID-19 vaccines technically need a CDC recommendation each season, Goad explained. Without what he described as a functioning ACIP, VRBPAC’s recommendation stands without support from the CDC.

“In lieu of that, what we have are associations such as the American Academy of Family Physicians and the American Academy of Pediatrics, who are making the recommendations now that providers should follow for the use of COVID-19 vaccines this season,” he explained.

Goad noted that ACIP also generally publishes a yearly Morbidity and Mortality Weekly Report (MMWR) with its influenza recommendations, although influenza vaccines do not technically need it from the FDA’s standpoint.

Goad also addressed vaccine stocking concerns for health maintenance organizations (HMOs) amid the recommendation uncertainty. He said all 4 available COVID-19 vaccines are “equally about as effective,” though they differ in their age indications.

He did note, however, that HMOs with a wide variety of patients may need to use Moderna’s Spikevax, which is approved for children as young as 6 months. Spikevax is approved for all adults 65 and older and for those 6 months through 64 years with at least 1 underlying condition that puts them at high risk for severe COVID-19.⁴ For mostly adult patient populations, “you could use any of the vaccines and stock any of them.”

References

1. COVID-19 vaccines (2026-2027 formula) for use in the United States beginning in fall 2026. FDA. May 29, 2026. Accessed October 1, 2026. https://www.fda.gov/vaccines-blood-biologics/industry-biologics/covid-19-vaccines-2026-2027-formula-use-united-states-beginning-fall-2026

2. McCrear S. COVID-19 may follow a different seasonal pattern than influenza, RSV. AJMC. June 29, 2026. Accessed October 1, 2026. https://www.ajmc.com/view/covid-19-may-follow-a-different-seasonal-pattern-than-influenza-rsv

3. McCrear S. COVID is back in the Bay Area: is it the XFG “Stratus” variant? AJMC. August 17, 2026. Accessed October 1, 2026. https://www.ajmc.com/view/covid-is-back-in-the-bay-area-is-it-the-xfg-stratus-variant-

4. Moderna receives U.S. FDA approval for updated 2026-2027 COVID-19 vaccines. News release. Moderna. August 27, 2026. Accessed October 1, 2026. https://www.nasdaq.com/press-release/moderna-receives-us-fda-approval-updated-2026-2027-covid-19-vaccines-2026-08-27